Liver failure is a condition in which the liver gets damaged and has lost its function (no longer able to work normally). It is an emergency, life-threatening condition – immediate treatment is necessary. How about the prognosis? Will the damage become permanent or is it reversible?
Most often, the decreased function of the liver occurs gradually over a long period of time (in months or years), also called chronic. But in a few cases, liver failure can also occur abruptly (in days or weeks), this is called acute. Immediate treatment is important for both acute and chronic liver failure.
A number of factors and conditions can contribute to cause the condition, these include:
- Viral hepatitis, especially hepatitis B (mostly) and sometimes hepatitis C.
- Chronic liver damage caused by a long-term, excessive alcohol use.
- Cirrhosis, scarring of the liver (when hard, abnormal scar tissues replace healthy tissues of the liver). If left untreated, it will make your liver have less healthy tissues and fail to function.
- Other medical conditions such as malnutrition disorder and hemochromatosis (a genetic condition that causes excessive accumulation of iron in the body).
But for acute liver failure, what causes the disease can sometimes be different, these include:
- Excessive medication use, most commonly Tylenol (acetaminophen).
- Extreme reaction to certain herbal or prescription medications.
- Viral infection such as hepatitis or other viruses.
- Ingestion of toxins such as poisonous wild mushrooms.
- Overwhelming blood poisoning can cause multiple organ failure.
- Certain medical conditions like autoimmune disease, metabolic disorder, vascular disease, and cancer.
Liver has many functions for sustaining life. If it gets malfunctioned, there are lots of consequences and complications which some could be fatal – these include [reference]:
- Jaundice skin, which is the most common specific symptom of the failure. When your liver is no longer able to function, waste products such as bilirubin can accumulate in the circulation. Excess bilirubin will be deposited in the skin, causing jaundice.
- Hypertension (high blood pressure), especially in the blood vessels that line from the intestine to the liver.
- Abdominal swelling caused by excessive accumulation of fluid within the abdomen.
- Gastrointestinal bleeding. New abnormal blood vessels that bypass the liver may develop, typically in the stomach and esophagus. They can enlarge or get twisted, and also be easy to bleed.
- More susceptible to bruise and bleed. This occurs when your liver is no longer able to normally synthesize proteins for blood clot.
- Decreased brain function since there will be more toxic substances that accumulate and build up in the blood. Without normal liver function, your body cannot optimally remove toxics.
- Other possible consequences include vulnerability to infection caused by the immune system malfunction, metabolic abnormalities, and sometimes kidney malfunction.
Since it is emergency condition, it often requires intensive care unit in hospital.
Treatment goal is to treat the damage of the liver and to control the complications. Doctors may need to treat the damage itself or give the liver adequate time to heal along with medications to control the symptoms and complications!
In general, here are important points to treat the disease:
- Immediate treatment especially for acute liver failure.
- Treating the underlying cause of the disease.
- Medications to relieve the symptoms and prevent the complications.
- Dietary approaches, especially diet low in fats or animal protein.
- And if necessary, liver transplantation which is usually the last treatment option.
So will the damage be permanent or reversible?
If the failure is identified early enough, it may be reversible – especially if the underlying cause of the condition is curable. But if it has become advanced, a liver transplant may be required.
For examples, acute liver failure caused by excessive acetaminophen use is often curable if treated early enough with appropriate medications (such as a medication called acetylcysteine) so the liver damage and its effects can be reversed. Likewise, if the failure is caused by viruses, early medications & extensive supportive cares can help treat the symptoms and prevent the complications until the virus goes away through its course – in such case, the liver may recover on its own depending on the severity of the damage.
For chronic liver failure, the initial goal of treatment is usually to rescue whatever healthy part of the liver and preserve the liver function. But if this option is not possible or if the failure cannot be reversed, the last option that can help is a liver transplant.
Liver transplant, if performed soon enough, is often successful to restore the liver function. It can help you to live as long as you would have especially if you don’t have any liver disorders.Unfortunately, not all patients with liver failure are suitable to get liver transplantation.